We have all seen children whose need to be in constant motion is at best distracting and at worst deeply disturbing. While parents and professionals (teachers, counselors, psychologists) have developed a variety of strategies to help such children settle down, at times the problem can seem to be intractable. This article is designed to help you get a handle on such behavior, both in terms of understanding its causes and in terms of finding ways to deal with it productively.

Evidence that the Child Has a Problem

We all know the scenario, whether we are observing children in our own family of dealing with a child sitting near us in a plane or at the movies. The child appears to be unable to keep still -- swinging an arm, kicking a leg, pushing or pulling an object or even a person, fidgeting. Such children have trouble maintaining body boundaries, often can’t keep their hands to themselves, repeatedly turn and stretch, throw and jump, and often annoy others. While it may seem that such a child is trying to be difficult, research has shown that there are physiological, neurological, and environmental reasons for such behavior.

Underlying Physical and Neurological Causes

Children who behave in the manners described frequently have sensory processing issues and/or low muscle tone. They may also have a weak trunk and spine or other medical or psychological problems.

Sensory processing disorders, in which the brain has trouble organizing information from the senses, can range from mild to severe. They make individuals oversensitive to sights, sounds, textures, flavors, and smells. This disorder makes the child not only easily distracted, but susceptible to irritability or outbursts.

Low Muscle Tone

Muscle tone refers to the amount of stretch muscles have while at rest. Low muscle tone makes it hard to sit still since while doing so we have to contract our muscles for extended periods of time. Children with low muscle tone are much more comfortable moving around because when they move they are using a greater number of muscle groups.

Weak Trunk and Spine

For a child with poor postural stability, sitting can be uncomfortable, even physically exhausting. For such children, sitting in a circle on the floor (often part of the program in the primary grades) is particularly difficult because their backs are unsupported.

Some Other Undiagnosed Medical or Psychological Problem

It should be remembered that a child may also have a particular problem with his or her physical or mental health that has not yet been diagnosed. A child with vision or hearing problems, digestive issues, allergies, or with some other medical or psychological issue that has not yet been addressed, may be more prone to act out.

Any child who has ongoing behavioral issues should be checked by both a medical professional and a well-credentialed psychologist to ensure that he or she is properly and comprehensively evaluated, since there may be more than one cause of the problem. Whatever the cause(s) of the difficulty, strategies have been developed, many through trial and error, and some through independent research, that are highly effective.

Environmental Causes

In a surprisingly high number of cases, children are squirming for reasons that are external and, if recognized, can be easily remedied. Some environmental reasons that children experience discomfort holding still include:

● They are overwhelmed by too many activities and don’t have sufficient downtime

● They spend too much time in front of various screens

● Their diet is unhealthy

● Their home life is stressful

● They do not have enough opportunities for social, or even familial, interaction

Most children in our culture are getting too little exercise and spend too much time watching TV or playing video games. We should encourage physical activity at every opportunity. Teachers and parents should remember that taking away recess or a trip to the park as a punishment for bad behavior is likely to backfire because, in all likelihood, the child needs more, not less, exercise.

Strategies to Help the Restless Child

There are several methods that have been used at home, at school, and on social occasions, with a high rate of success. These include having the child:

● Engage in physical activity prior to sitting

● Take frequent breaks during which he or she can move around

● Chew sugarless gum or suck on sugarless candy

● Play with a small fidget toy, such as a koosh ball or a spinner

● Engage in a muscle strengthening program of exercise

● Use a device called a Move-N-Sit, or Disco-Sit cushion on his or her chair

While some of these suggestions may seem counterintuitive because they appear to be distracting, they have been shown to help children concentrate on the task at hand because they have the opportunity to expend excessive energy. Examples of physical activities before a period of sitting may include, depending on where the child is, erasing the blackboard, transporting a heavy load of books to another classroom, carrying luggage or other items out to the car, or running around the grounds of an outdoor event before the performance begins.

All of the above-mentioned suggestions are based on giving the child a chance to exercise muscles and joints (even if just muscles of the mouth and jaw or the buttocks and thighs). This muscular activity be effective in calming the child and helping to regulate his or her overstimulated nervous system. As far as exercises to improve muscle strength are concerned, a healthcare professional or occupational therapist should be consulted to make sure the most effective methods are being used. Also, most behavioral professionals agree that fidget toys should be offered as rewards for good behavior and taken away if they are misused or become distracting to others.

Hopefully, this article encourages you, as a responsible adult in the child’s life, to explore the many possible reasons that the child may be having trouble sitting still. Early intervention in such behavioral problems can make a tremendous, long-lasting difference in the child’s quality of life, not to mention yours.

About The Author

Jacob Boney, Psy.D., BCBA-D created Scottsdale Pediatric Behavioral Services with the goal of making behavior analysis available to parents and professionals who wish to practice, teach and disseminate behavior science